A Collaborative Analysis of Individual Participant Data from 19 Prospective Studies Assesses Circulating Vitamin D and Prostate Cancer Risk.

Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics. Principal investigators of 19 prospective studies provided individual participant data on circulating 25(OH)D and 1,25(OH)2D for up to 13,462 men with incident prostate cancer and 20,261 control participants. ORs for prostate cancer by study-specific fifths of season-standardized vitamin D concentration were estimated using multivariable-adjusted conditional logistic regression. 25(OH)D concentration was positively associated with risk for total prostate cancer (multivariable-adjusted OR comparing highest vs. lowest study-specific fifth was 1.22; 95% confidence interval, 1.13-1.31; P trend < 0.001). However, this association varied by disease aggressiveness (P heterogeneity = 0.014); higher circulating 25(OH)D was associated with a higher risk of nonaggressive disease (OR per 80 percentile increase = 1.24, 1.13-1.36) but not with aggressive disease (defined as stage 4, metastases, or prostate cancer death, 0.95, 0.78-1.15). 1,25(OH)2D concentration was not associated with risk for prostate cancer overall or by tumor characteristics. The absence of an association of vitamin D with aggressive disease does not support the hypothesis that vitamin D deficiency increases prostate cancer risk. Rather, the association of high circulating 25(OH)D concentration with a higher risk of nonaggressive prostate cancer may be influenced by detection bias. SIGNIFICANCE: This international collaboration comprises the largest prospective study on blood vitamin D and prostate cancer risk and shows no association with aggressive disease but some evidence of a higher risk of nonaggressive disease

Health, nutrition and growth in infancy - a child health care perspective

Abstract Early childhood is recognised as a key period for the new family in which to promote health. There is evidence that infant feeding is one of the most influential factors affecting growth, development and life-long health. The aim of this thesis was to study infant food and feeding, as well as the impact of different feeding practices in infancy on early growth in childhood and, to explore parental views and considerations relating to child health. The Halland Health and Growth Study (H2GS) is a prospective, longitudinal, population-based, birth cohort study of 2666 infants in Halland, in south-western Sweden, between 1 October 2007 and 31 December 2008. A purposive sample of 16 parents was interviewed, after which the interviews were transcribed verbatim and analysed with content analysis. In the content analysis, six descriptive categories were identified: body and soul; parental behaviour; good enough parenting; interaction; growth; food and feeding issues. The parents perceived food and feeding issues as one of the most worrying aspects and a significant indicator of the concept of child health. With the parental desire to have a happy, contented child there is a risk of developing long-term, unhealthy feeding habits if and when the child is given something to eat in order to attain this state of mind. Almost a third (26.9%) reported breastfeeding problems, which is associated with early breastfeeding cessation. There was a significant correlation between breastfeeding problems and poor sucking technique and perceived poor weight gain. There was no association between breastfeeding or formula feeding at four months and a high BMI at 12 or 18 months. At six months, a positive correlation was found between gruel feeding and a high BMI at 12 and 18 months respectively. Many mothers breastfeed at six months (58.3%), but very few (1.6%) adhered to the recommendations of exclusive breastfeeding at six months. It was more common among parents with low education to choose milk cereal drink. The proportion of mothers not breastfeeding at four months was significantly associated with low neighbourhood purchasing power. After adjusting for maternal age, smoking and parental level of education, the corresponding odds ratio (1.63 (95% CI 1.07-2.56)) was significant and the trend across the strata was still evident. A multi-level analysis estimated that, in neighbourhoods where > 30% of the families had low purchasing power, 20% more mothers than expected, reported no breastfeeding at four months. Almost a third of the mothers reported breastfeeding problems, which can be prevented, but the timing is crucial. Further evidence that privileged mothers with high purchasing power are less likely to stop breastfeeding before four months was found. The neighbourhood purchasing power provided a spatial determinant of the number of mother’s breastfeeding at four months, which could be relevant when allocating resources for preventive measures. At six months very few mothers, 1.6% adhered to the recommendation on exclusive breastfeeding. None of the feeding habits during the first four months had any effect on a high BMI at 12 or 18 months of age. Milk cereal drink use at six months was a risk factor for a high BMI at 12 and 18 months. It was more common among parents with low education to choose milk cereal drink. The parents perceived food and feeding issues as important indicators of child health. These findings, suggest that a lack of responsiveness to parental beliefs and concerns may jeopardise the credibility of healthy infant diet messages

Experiences of undergoing Internet-based cognitive behavior therapy for procrastination: A qualitative study

Internet interventions constitute a promising and cost-effective treatment alternative for a wide range of psychiatric disorders and somatic conditions. Several clinical trials have provided evidence for its efficacy and effectiveness, and recent research also indicate that it can be helpful in the treatment of conditions that are debilitating, but do not necessarily warrant more immediate care, for instance, procrastination, a self-regulatory failure that is associated with decreased well-being and mental health. However, providing treatment interventions for procrastination via the Internet is a novel approach, making it unclear how the participants themselves perceive their experiences. The current study thus investigated participants' own apprehension of undergoing Internet-based cognitive behavior therapy for procrastination by distributing open-ended questions at the post-treatment assessment, for instance, “What did you think about the readability of the texts”, “How valuable do you believe that this treatment has been for you?”, and “The thing that I am most displeased with (and how it could be improved) is …”. In total, 75 participants (50%) responded, and the material was examined using thematic analysis. The results indicate that there exist both positive and negative aspects of the treatment program. Many participants increased their self-efficacy and were able to gain momentum on many tasks and assignments that had been deferred in their everyday life. Meanwhile, several participants lacked motivation to complete the exercises, had too many conflicting commitments, and were unable to keep up with the tight treatment schedule. Hence, the results suggest that Internet interventions for procrastination could profit from individual tailoring, shorter and more manageable modules, and that the content need to be adapted to the reading comprehension and motivational level of the participant

Depressive symptoms postpartum is associated with physical activity level the year prior to giving birth - A retrospective observational study

Objectives: To examine physical activity level prior to pregnancy, during pregnancy and postpartum and investigate the association with depressive symptoms postpartum among women in Sweden. Study design: Retrospective observational study including 532 women on self-assessment of physical activity level before pregnancy, during pregnancy and postpartum, depressive symptoms postpartum as well as stressful life events in the past two years. Main outcome measures: Level and change of physical activity before pregnancy, during pregnancy and postpartum and depressive symptoms postpartum. Results: Almost two-thirds of the women in the study reported that they were inactive or performed light physical activity (62.9%; n = 331) in the year prior to giving birth. Women with a sedentary lifestyle or performing light physical activity level reported depressive symptoms postpartum to a greater extent than active women. Conclusions: A higher level of physical activity during pregnancy was associated with a lower level of depressive symptoms postpartum. Physical activity is a contributing factor to promote a healthier lifestyle and can contribute to improve mental health for pregnant women, newly become mothers and their children.Funding Agencies|national health board and distributed by the Region of Halland; Region of Halland</p

How to support child healthcare nurses in sweden to promote healthy lifestyle behaviors from the start of life

Child healthcare (CHC) nurses have a key role in promoting and supporting healthy lifestyle behaviors from a young age. Thus, this study aims to investigate the perspectives of CHC nurses regarding discussing food introduction, physical activity/active play, and screen time with parents; explore facilitators and barriers influencing the discussion of healthy lifestyle behaviors with parents; and explore the perspectives of CHC nurses regarding a complementary program to promote healthy lifestyle behaviors from the start of life. A total of fifteen nurses participated in semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using thematic analysis. There were four themes that were generated: parental needs; facilitators and barriers; parental groups; and future working methods. This study found that CHC nurses have seen an increase in the need for support among today’s parents. Time, the need to tailor information, and confidence to address sensitive topics were perceived as the largest barriers during daily work for the nurses. Furthermore, large variations in parental groups were found. Finally, the CHC nurses displayed a willingness and openness to change and develop current working methods using digital solutions. These solutions could possibly ease the workload and at the same time, support parents to create healthy lifestyle behaviors from the start of their child’s life.</jats:p

Study protocol for an effectiveness-implementation hybrid trial to evaluate a health promotion intervention in parents and their 5-year-old child : Saga Stories in health talks in Swedish child healthcare.

BACKGROUND: Unhealthy lifestyle behaviours such as a poor diet, inadequate physical activity, and excessive screen time have been shown to be established in childhood and track into adulthood, demonstrating the need for health promotion interventions in the pre-school years. The overall aim of this project is to: (i) evaluate the effectiveness of `Saga Stories in health talks´ within child healthcare (CHC) on parental self-efficacy to promote healthy diet, physical activity, and screen time behaviours in their child; children's intake of key dietary indicators and screen time and (ii) evaluate and explore the implementation of `Saga Stories in health talks´ with regards to acceptability, appropriateness, feasibility, fidelity, adoption, sustainability, satisfaction, and usage. METHODS: A hybrid type I effectiveness-implementation trial will be conducted. A cluster randomized controlled trial will be used to assess the effectiveness of `Saga Stories in health talks´ in 42 CHC centers across six regions in Sweden. `Saga Stories in health talks´ consists of material for CHC nurses to use to facilitate the health talk with both the child and parent(s) and is complemented with take-home material. Parent and child dyads are recruited (n = 450) from participating CHC centers when they attend their 5-year routine visit. The intervention group receives the health talk using Saga Stories and take-home material, whereas the control group receives the standard health talk. The primary outcome is parental self-efficacy to promote healthy diet, physical activity, and screen time behaviours in their child and secondary outcomes include children's intake of key dietary indicators and screen time. All outcomes are assessed at baseline and 2-months post-intervention. The implementation outcomes that will be assessed are: acceptability, appropriateness, feasibility, satisfaction, usage, fidelity, adoption, and sustainability (assessed quantitatively and qualitatively). DISCUSSION: The Swedish National Board of Health and Welfare have identified the need of more material, education, and working methods for promoting healthy lifestyle behaviours in CHC. Following this trial `Saga Stories in health talks´ has great potential to be implemented in CHC across Sweden to aid nurses to promote and support healthy lifestyle behaviours in pre-school children and their families. TRIAL REGISTRATION: ClinicalTrials.gov , NCT05237362 . Registered 2 February 2022

Nutrition- and feeding practice-related risk factors for rapid weight gain during the first year of life : a population-based birth cohort study

Background: Rapid weight gain (RWG) during infancy increases the risk of excess weight later in life. Nutrition- and feeding practices associated with RWG need to be further examined. The present study aimed to examine nutrition- and feeding practice-related risk factors for RWG during the first year of life. Methods: A population-based longitudinal birth cohort study of 1780 infants, classified as having RWG or non-RWG during 0–3-4, 0–6 and 6–12 months. RWG was defined as a change &gt; 0.67 in weight standard deviation scores. Associations between nutrition- and feeding practice-related factors and RWG were examined with logistic regression models. Results: Of the participating infants, 47% had RWG during 0–3-4 months, 46% during 0–6 months and 8% during 6–12 months. In the fully adjusted models, bottle-feeding at birth and at 3–4 months and nighttime meals containing formula milk were positively associated with RWG during 0–3-4 months (p &lt; 0.05 for all). Breastfeeding at 3–4 months and nighttime meals containing breast milk were negatively associated with RWG during this period (p &lt; 0.001). Bottle-feeding at birth, 3–4 and 6 months and nighttime meals containing formula milk at 3–4 months were positively associated with RWG during 0–6 months (p &lt; 0.01 for all). Breastfeeding at 3–4 and 6 months was negatively associated with RWG (p &lt; 0.01). During 6–12 months, only bottle-feeding at 3–4 months was positively associated with RWG (p &lt; 0.05). Conclusions: RWG was more common during the first 6 months of life and bottle-feeding and formula milk given at night were risk factors for RWG during this period. © 2020, The Author(s).Funding: This work was supported by grants from Region Halland, Research and Development Center Spenshult, Her Royal Highness Crown Princess Lovisa’s Association for Child Care/Axel Tielmans Memorial Fund and Halmstad University. The funding bodies were not involved in the design of the study, data collection, analysis or interpretation of data or in the writing of the manuscript. Open Access funding provided by Halmstad University Library.</p